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• St. Columba Catholic Church Community Registration

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  • Family Name REQUIRED Please fill out this field. Please enter valid data.
  • Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Email Address Please enter valid data.
  • Would you like to receive Parish Envelopes? Yes No
  • Catholic Marriage Single Catholic Marriage Civil Marriage Separated Divorced Widowed
  • First Name Please enter valid data.
  • Maiden Name Please enter valid data.
  • Date of Birth (Mo/Day/Year) Please enter valid data.
  • Religion Please enter valid data.
  • Occupation Please enter valid data.
  • Cell Phone Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • Spouse Please enter valid data.
  • Maiden Name Please enter valid data.
  • Date of Birth (Mo/Day/Year) Please enter valid data.
  • Religion Please enter valid data.
  • Occupation Please enter valid data.
  • Cell Phone Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
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    Complete the following information for children (under 18) living in the home:
  • NAME Please enter valid data.
  • Date of Birth Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • Name Please enter valid data.
  • Date of Birth Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • Name Please enter valid data.
  • Date of Birth Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • Name Please enter valid data.
  • Date of Birth Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • Name Please enter valid data.
  • Date of Birth Please enter valid data.
  • Sacraments Received Baptism First Communion Confirmation
  • 
     
  • Sunday Envelopes: Yes No
  • Catholic Voice: Yes No
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    FOR OFFICE USE ONLY
    
    Date Received:
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